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Primary dapsone-resistant leprosy in Cebu, Philippines
Summary
A study in Cebu, Philippines, found primary dapsone-resistant leprosy in 3.6% of cases. Most Mycobacterium leprae strains remained susceptible to dapsone, but two showed resistance in mouse models.
Area of Science:
- Medical Microbiology
- Tropical Medicine
- Epidemiology
Background:
- Leprosy remains a significant public health concern globally.
- Dapsone has been the cornerstone of multidrug therapy for leprosy.
- Emergence of drug resistance can compromise treatment efficacy and disease control.
Purpose of the Study:
- To determine the prevalence of primary dapsone resistance in leprosy patients in Cebu, Philippines.
- To characterize the susceptibility of Mycobacterium leprae isolates to dapsone.
Main Methods:
- A survey was conducted to identify leprosy patients in Cebu.
- Susceptibility testing was performed using mouse models inoculated with Mycobacterium leprae isolates.
- Minimal effective dose and a 10-fold higher dose of dapsone were administered to mice.
Main Results:
- The prevalence of primary dapsone-resistant leprosy was estimated at 3.6 per 100 patients.
- Out of 55 patients, 53 had Mycobacterium leprae fully susceptible to dapsone.
- Mycobacterium leprae from two patients multiplied in mice receiving the minimal effective dapsone dose; one isolate also multiplied at a 10-fold higher dose.
Conclusions:
- Primary dapsone resistance in leprosy exists in Cebu, Philippines, at a notable prevalence.
- While most isolates remain susceptible, the identification of resistant strains necessitates ongoing surveillance.
- Further research is needed to understand the mechanisms and implications of dapsone resistance in leprosy.